Continuing Care Performance Report glossary

Alternative Care (AC): Home and community-based services for Minnesotans age 65 years and older who are at risk of nursing home placement and are not yet financially eligible for Medical Assistance.

Brain Injury (BI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person and who would otherwise require the level of care provided in a specialized nursing facility or neurobehavioral hospital.

Case Mix Classification: Classification of a person for the purposes of establishing payment levels that relies on the ability to complete certain activities of daily living (ADL) the need for behavioral interventions and clinical or nursing care required. Case Mix classification was developed as a payment system for nursing facilities and used for establishing individual community budgets under various programs.

Cohort:Cohorts (PDF) are groups of counties established based on the home and community-based waiver caseload size of each county for the Waiver Review. The state is divided into five cohort groups. Cohort 1 includes the 26 counties serving the fewest number of people in their waiver programs. Cohort 2 includes 26 moderately small sized counties. Cohort 3 has 22 mid-sized counties. Cohort 4 has five moderately large counties. Cohort 5 has Minnesota's five largest counties that serve the most people in their waiver programs. Refer to the county map of Minnesota's 87 counties and their designated cohort.

Community Access for Disability Inclusion (CADI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who would otherwise require the level of care provided in a nursing facility.

Community Alternative Care (CAC) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who is chronically ill or medically fragile and who would otherwise require the level of care provided in a hospital.

Developmental Disabilities (DD) Waiver: Home and community based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who meets the waiver eligibility criteria and who would require the level of care provided in an Intermediate Care Facility for Persons with Developmental Disabilities.

Disability Waivers: For the purposes of the performance measures, the disability waivers include Community Alternatives for Care (CAC), Community Alternatives for Disabled Individuals (CADI) and Brain Injury (BI) waivers only.

Earnings: Income earned by an individual including income from wages and self-employment.

Elderly Waiver (EW): Home and community-based services as an alternative to institutionalization that promotes the optimal health, independence, and safety of a person age 65 years or older, who would otherwise require the level of care provided in a nursing facility.

High needs for people with developmental disabilities: People on the Developmental Disabilities Waiver who have a Profile 1, 2 or 3. This indicates they have higher needs and require more support. This does not include people who are Profile 4, which means they are more independent and need less assistance with daily living.

High needs for people with disabilities (excluding developmental disabilities): People on one of the disability waivers (CAC, CADI and BI) who are not case mix A or L. Case mix A and L are people who are more independent and who need less assistance with daily living.

High needs for seniors: People on EW and AC who are not in case mix A or L group. Case mix A and L refer to a group of people who are more independent and who need less assistance with daily living.

Home and Community-Based Services (HCBS): Services provided in a person's home, residence or community under various state and federal waivered programs. These services are not provided in an institutional setting. HCBS primarily includes waiver and home care services.

HCBS for people with developmental disabilities: Services provided in a person's home or community. This includes services provided through the Developmental Disabilities Waiver, home care for people with DD under age 65, MNDHO and Consumer Support Grants for people with DD.

HCBS for people with disabilities (excluding developmental disabilities): Services provided in a person's home or community. This includes services provided through the CAC, CADI and BI waivers, home care for people with disabilities under age 65, MNDHO and Consumer Support Grants. State plan home care paid by health plans is included.

HCBS for seniors: Services provided in a person's home. This includes services provided through the Elderly Waiver (fee-for-service and managed care), Alternative Care and FFS home care for persons age 65 and older purchased through both fee-for-service and health plans.

Home and Community-Based Services (HCBS) Waiver: Services not normally covered by MA, which are covered under a 1915 (c) federally funded waiver program or through state funds. HCBS waivers allow states flexibility to cover virtually all long-term care services that persons with disabilities need to live independently in home and community settings. States may operate several 1915 (c) HCBS waiver programs at once, each offering a distinct package of services and supports to a different group of persons.

Institutional services for people with developmental disabilities: Services for people with developmental disabilities include intermediate care facilities (ICFs) and nursing home services for people who are under 65 years of age.

Institutional services for people with Disabilities (excluding Developmental disabilities): Services for people with disabilities who are under 65 years of age include nursing home services, residential treatment facilities (Rule 5), neurobehavioral hospitals and state operated residential treatment facilities paid by Medical Assistance. Services provided in state operated residential treatment facilities designated as Institutions for Mental Disease (e.g. Anoka) are not included.

Institutional services for seniors: Services for people 65 years of age and older provided in a nursing home.

Long-Term Care (LTC) Services: Services likely needed by a person on an ongoing and continuous basis. LTC services can be provided as home and community-based services or as institutional services.

Low needs for people with developmental disabilities: People on the Developmental Disabilities Waiver who are Profile 4. This means they are more independent and need less assistance.

Low needs for people with disabilities (excluding developmental disabilities): People on one of the disability waivers (CAC, CADI and BI) who are case mix A or L. Case mix A and L include people who are more independent and who need less assistance with daily living.

Low needs for seniors: People on EW and AC who are case mix A or L. Case mix A and L are people who are more independent and who need less assistance with daily living.

Low needs for residents of nursing facilities: Nursing facility staff must assess residents at least every 90 days to determine their care needs. Residents with the lowest care needs are classified in the Reduced Physical Function-1 (PA1) group. This means that they do not have problems with behavior or memory. They need very little or no help with physical activities like eating, toileting and getting around.

Minimum Data Set (MDS): Assessment of resident preferences and medical conditions that nursing facility staff are required to complete at admission and at least quarterly thereafter.

Performance-based Incentive Payment Program (PIPP): Established by the Minnesota Legislature in 2006. PIPP uses a competitive application process to fund innovative nursing facility provider-initiated projects that meet program goals of higher quality, greater efficiency and more appropriate use of long-term care resources.

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Terminology disclaimer
The terminology used to describe people with disabilities has changed over time. The Minnesota Department of Human Services (“Department”) supports the use of “People First” language. Although outmoded and offensive terms might be found within documents on the Department’s website, the Department does not endorse these terms.